Long-term strategies to control COVID-19 in low and middle-income countries: An options overview of community-based, non-pharmacological interventions
This article was published in The European Journal of Epidemiology [©2020 Published by Springer, Open access, licensed under CC BY-NC-ND 4.0] and the definite version is available at: https://doi.org/10.1007/s10654-020-00660-1 The Article's website is at: https://link.springer.com/article/10.10...
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| Länkar: | http://hdl.handle.net/10361/16269 https://doi.org/10.1007/s10654-020-00660-1 |
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10361-162692022-03-27T05:45:56Z Long-term strategies to control COVID-19 in low and middle-income countries: An options overview of community-based, non-pharmacological interventions Chowdhury, Rajiv Luhar, Shammi Khan, Nusrat Choudhury, Sohel Reza Matin, Imran Franco, Oscar H. BRAC Institute of Governance and Development Covid-19 Exit plan Local lockdown Low and middle-income countries Mitigation Non-pharmacological interventions Zonal lockdown This article was published in The European Journal of Epidemiology [©2020 Published by Springer, Open access, licensed under CC BY-NC-ND 4.0] and the definite version is available at: https://doi.org/10.1007/s10654-020-00660-1 The Article's website is at: https://link.springer.com/article/10.1007/s10654-020-00660-1 In low and middle-income countries (LMICs), strict social distancing measures (e.g., nationwide lockdown) in response to the COVID-19 pandemic are unsustainable in the long-term due to knock-on socioeconomic and psychological effects. However, an optimal epidemiology-focused strategy for ‘safe-reopening’ (i.e., balancing between the economic and health consequences) remain unclear, particularly given the suboptimal disease surveillance and diagnostic infrastructure in these settings. As the lockdown is now being relaxed in many LMICs, in this paper, we have (1) conducted an epidemiology-based “options appraisal” of various available non-pharmacological intervention options that can be employed to safely lift the lockdowns (namely, sustained mitigation, zonal lockdown and rolling lockdown strategies), and (2) propose suitable application, pre-requisites, and inherent limitations for each measure. Among these, a sustained mitigation-only approach (adopted in many high-income countries) may not be feasible in most LMIC settings given the absence of nationwide population surveillance, generalised testing, contact tracing and critical care infrastructure needed to tackle the likely resurgence of infections. By contrast, zonal or local lockdowns may be suitable for some countries where systematic identification of new outbreak clusters in real-time would be feasible. This requires a generalised testing and surveillance structure, and a well-thought out (and executed) zone management plan. Finally, an intermittent, rolling lockdown strategy has recently been suggested by the World Health Organization as a potential strategy to get the epidemic under control in some LMI settings, where generalised mitigation and zonal containment is unfeasible. This strategy, however, needs to be carefully considered for economic costs and necessary supply chain reforms. In conclusion, while we propose three community-based, non-pharmacological options for LMICs, a suitable measure should be context-specific and based on: (1) epidemiological considerations, (2) social and economic costs, (3) existing health systems capabilities and (4) future-proof plans to implement and sustain the strategy. Published 2022-02-17T09:54:46Z 2022-02-17T09:54:46Z 2020 2020-08 Journal Article http://hdl.handle.net/10361/16269 https://doi.org/10.1007/s10654-020-00660-1 en_US https://link.springer.com/article/10.1007/s10654-020-00660-1 European Journal of Epidemiology Springer Link |
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Brac University |
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Institutional Repository |
| language |
en_US |
| topic |
Covid-19 Exit plan Local lockdown Low and middle-income countries Mitigation Non-pharmacological interventions Zonal lockdown |
| spellingShingle |
Covid-19 Exit plan Local lockdown Low and middle-income countries Mitigation Non-pharmacological interventions Zonal lockdown Chowdhury, Rajiv Luhar, Shammi Khan, Nusrat Choudhury, Sohel Reza Matin, Imran Franco, Oscar H. Long-term strategies to control COVID-19 in low and middle-income countries: An options overview of community-based, non-pharmacological interventions |
| description |
This article was published in The European Journal of Epidemiology [©2020 Published by Springer, Open access, licensed under CC BY-NC-ND 4.0] and the definite version is available at: https://doi.org/10.1007/s10654-020-00660-1 The Article's website is at: https://link.springer.com/article/10.1007/s10654-020-00660-1 |
| author2 |
BRAC Institute of Governance and Development |
| author_facet |
BRAC Institute of Governance and Development Chowdhury, Rajiv Luhar, Shammi Khan, Nusrat Choudhury, Sohel Reza Matin, Imran Franco, Oscar H. |
| format |
Journal Article |
| author |
Chowdhury, Rajiv Luhar, Shammi Khan, Nusrat Choudhury, Sohel Reza Matin, Imran Franco, Oscar H. |
| author_sort |
Chowdhury, Rajiv |
| title |
Long-term strategies to control COVID-19 in low and middle-income countries: An options overview of community-based, non-pharmacological interventions |
| title_short |
Long-term strategies to control COVID-19 in low and middle-income countries: An options overview of community-based, non-pharmacological interventions |
| title_full |
Long-term strategies to control COVID-19 in low and middle-income countries: An options overview of community-based, non-pharmacological interventions |
| title_fullStr |
Long-term strategies to control COVID-19 in low and middle-income countries: An options overview of community-based, non-pharmacological interventions |
| title_full_unstemmed |
Long-term strategies to control COVID-19 in low and middle-income countries: An options overview of community-based, non-pharmacological interventions |
| title_sort |
long-term strategies to control covid-19 in low and middle-income countries: an options overview of community-based, non-pharmacological interventions |
| publisher |
Springer Link |
| publishDate |
2022 |
| url |
http://hdl.handle.net/10361/16269 https://doi.org/10.1007/s10654-020-00660-1 |
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